The goal of the West Virginia Clinical and Translation Science Institute's (WVCTSI) IDeA-CTR application is to expand our infrastructure for, and practice of, clinical and translational research to a level competitive for a Clinical and Translational Science Award (CTSA). To this end, the WVCTSI was established in 2008 as the organizational home supporting research to address the health and healthcare needs of the people of West Virginia and Central Appalachia, and ultimately to eliminate health disparities. To realize our ambitious goal, the WVCTSI, which includes West Virginia University, Charleston Area Medical Center, West Virginia School of Osteopathic Medicine, and West Virginia United Health Systems, has partnered with the Appalachian Translational Research Institute, which was founded by our IDeA state partner and CTSA recipient the University of Kentucky. The WVCTSI will achieve its goal through pursuit of three aims: 1) Grow the WVCTSI as an academic home and a catalyst for clinical and translational research that targets cancer, cardiovascular-stroke, and obesity related diseases; 2) Establish cross cutting research partnerships among the WVCTSI partnered institutions and collaborating CTSAs at University of Kentucky, Ohio State University, and Indiana University to increase our research capacity; and 3) Utilize innovative recruitment, training, and mentoring strategies to develop clinical and translational scientists at each of the WVCTSI institutions. These aims are addressed through recruitment and support of clinical and translational scientists and a broad educational and mentoring program. In addition, participating faculty are provided with research resources that include biostatistics, clinical informatics, and access to a range of pilot funding mechanisms. Furthermore, mechanisms to streamline regulatory processes without compromising human subject protections and to engage communities fully in the research agenda are being developed. Finally, to ensure accountability and quality improvement, a robust evaluation program has been established. Overall, the WVCTSI has developed a strong infrastructure to increase the number of extramural funded clinical and translational researchers and has a well-considered plan for enhancing capacity and productivity over the next five years, positioning us for competitiveness for a CTSA.